ECT/TMS
Which of the following medications is least likely to interfere in patient’s treatment response to ECT or worsen ECT-related adverse event?
a) Depakote
b) Bupropion
c) Lithium
d) Benzodiazepines
e) Haloperidol
e. Haloperidol
Lithium has a significant risk of delirium, prolonged seizures, toxic lithium levels, and prolonged neuromuscular blockade when combined with ECT.
Depakote increases seizure threshold during ECT.
Benzodiazepines can cause increased seizure threshold, decreased seizure duration, and decreased potential efficacy of ECT.
Bupropion decreases seizure threshold and can cause prolonged seizures with ECT treatment.
Which of the following is the best tool to measure the degree of self-care in children with intellectual disabilities?
A. Vineland Adaptive Behavioral Scale
B. Wechsler Adult Intelligence Scale
C. Trail Making Test
D. Wisconsin Card Sorting Test
Vineland Adaptive Behavioral Scale
The Vineland Adaptive Behavior Scale (VABS) is a commonly used measure of adaptive behavior skills for children and adolescents up to 18 years of age. In addition to providing an overall composite score, it consists of three subscales: (a) communication (receptive, expressive, written), (b) socialization (interpersonal relationships, play and leisure, coping skills), and (c) daily living (person, domestic, community).
A 40-year-old male presents to the outpatient clinic complaining of lower extremity discomfort for the past few months. He states that the discomfort is primarily at night prior to falling asleep and he describes it as shooting pains that get better when standing or walking. Which of the following would be the most appropriate treatment?
A. Haloperidol
B. Sertraline
C. Ropinirole
D. Cyproheptadine
E. Levetiracetam
Answer C
The condition described in this case is restless leg syndrome the FDA approved treatment for restless leg syndrome is ropinirole. Ropinirole is a dopamine agonist which can improve symptoms at low doses starting at 0.5 mg prior to bedtime. Restless leg syndrome is most often seen in middle to older age patients and is usually idiopathic. Patients often describe the symptoms as a crawling or creeping sensation of the lower extremities which is worse when lying down prior to sleep onset and improves with movement.
A 4 year old preschooler misses his long-term nanny who has recently moved away. To help this child, the parents should:
a. Consult pediatrician
b. Show pictures of the nanny
c. Hire a new nanny with similar features
d. Call the nanny and offer her a raise
Ans. B.
show pictures of the nanny. In Separation anxiety disorder may present panic or temper tantrums at times of separation from parents or caregiver.
A 34 year old female undergoes ECT for catatonia. All of the following can present as immediate side effects of bilateral electrode placement of ECT except:
A.) anterograde amnesia he
B.) retrograde amnesia
C.) Delirium
D.) Myocardial Infarction
E) respiratory depression
a. Anterograde amnesia
Anterograde amnesia is not 3 to 6 months post ECT treatment.
Which of the following is used for assessment of expressive language?
A. Boston Naming Test
B. Stroop Color Word Test
C. Rorschach Inkblot Test
D. Wisconsin Card Sorting Test
A. Boston Naming Test
The Boston Naming Test is used to measure confrontational word retrieval in individuals with aphasia or other language disturbance caused by stroke, Alzheimer's disease, or other dementing disorder. The patient is shown target stimuli and asked to identify each target item within a 20-second interval per trial. The examiner writes down the patient’s responses in the Response Booklet. If the patient fails to give the correct response initially, the examiner provides a phonemic cue, which is the initial sound of the target word (e.g., "moo" for "moose").
A 32-year-old male presents to outpatient clinic complaining of depressive symptoms. Patient’s history is significant for a gastric ulcer. Which of the following treatment options would be the most appropriate?
A. Amoxapine
B. Citalopram
C. Trazodone
D. Amitriptyline
E. Paroxetine
Answer D
Amitriptyline can be used for gastric ulcer because of its strong histamine blockade. Other drugs to consider for this purpose include doxepin and trimipramine.
a. Classical Conditioning theory
b. Operant Conditioning theory
c. Rapprochement theory
d. 2-Hit hypothesis
e. Translational Theory
Ans. A.
Systemic Desensitization therapy is derived from: Classical Conditioning theory. Systematic desensitization is a type of behavioral therapy based on the principle of classical conditioning. It was developed by Wolpe during the 1950s.
This therapy aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning. The number of sessions required depends on the severity of the phobia. Usually 4-6 sessions, up to 12 for a severe phobia. The therapy is complete once the agreed therapeutic goals are met (not necessarily when the person’s fears have been completely removed).
Exposure can be done in two ways:
· In vitro – Patient imagines exposure to the phobic stimulus.
· In vivo – Patient is actually exposed to the phobic stimulus.
TMS for treatment of depression targets which regions of the brain?
A. Frontotemporal cortex
B. Temporal cortex
C. Prefrontal cortex
D. Parietal cortex
c. Prefrontal cortex
TMS is usually applied over the left dorsolateral prefrontal cortex (DLPFC) and the treatment response mechanism is based on modulations in functional networks, particularly the mesocorticolimbic reward circuit.
The term for abnormally slow speech is
A. Alogia
B. Poverty of content
C. Bradylalia
D. Abulia
E. Apraxia
F. Neologism
Bradylalia
Bradylalia is abnormally slow speech, such as seen in depression.
Alogia (poverty of speech) is when the patient's replies tend to be restricted and are brief, concrete, and unelaborated.
Poverty of content is when replies are adequate in amount but tend to be vague, overgeneralized, and convey little information.
Abulia: abnormal lack of will to act or make decisions
Apraxia: Inability to coordinate complex oral movements needed to create sounds
Which of the following is the least anticholinergic?
A. Nortriptyline
B. Imipramine
C. Desipramine
D. Amitriptyline
E. Maprotiline
Answer C
Desipramine is the least anticholinergic of all of the tricyclic antidepressants. Amitriptyline, imipramine, and doxepin are the most anticholinergic. Anticholinergic side effects include dry mouth, blurred vision, constipation, and urinary retention. Since discipline mean is the least anticholinergic it is also best for someone with prostatic hypertrophy.
In biofeedback, the autonomic nervous system can come under voluntary control through which of following mechanisms?
a. Classical Conditioning
b. Operant Conditioning
c. Rapprochement theory
d. 2-Hit hypothesis
e. Translational Theory
b. Operant conditioning is described as a type of learning which is based on the behavioral patterns, taken place in response to numerous rewards and outcomes. Operant conditioning theory involves voluntary behavioral outcomes. Skinner’s rat box experiment became the base for the introduction of operant conditioning theory with its concepts.
Operant Conditioning takes place with the involvement of two major concepts including reinforcements and punishments following the behavior which will result in either an increase or decrease of the acquired behavior.
A patient with a history of melancholic depression is dehydrated, emaciated, and catatonic. He is withdrawn, talking about death and stops eating and drinking, lost 20 lbs. What is the treatment of choice?
A. Fluoxetine
B. Mirtazapine
C. TMS
D. ECT
d. ECT is an effective treatment of catatonia. ECT is effective in the resolution of both cardinal (primary) and secondary signs of catatonia.
Which test is an objective measure of the personality of adults and is helpful in confirming the diagnosis of personality disorder?
A. Millon clinical multiaxial inventory (MCMI)
B. Thematic apperception test (TAT)
C. Wisconsin card sorting test (WCST)
D. Beck anxiety inventory (BAI)
MCMI.
Millon clinical multiaxial inventory is an objective measure of personality tests, consisting of 195 True/False questions designed to test and diagnose personality disorders in a patient.
Thematic apperception test is a projective test in which patients are shown a series of provocative yet ambiguous pictures and are asked to tell a story. It reveals a person's perception of interpersonal relationships.
Wisconsin card sorting test is used for concept formation, reasoning, and executive functioning. It is commonly used neuropsychological test and measures executive functioning in terms of concept formation, planning and cognitive flexibility, visual spatial working memory, deductive reasoning and problem solving. It primarily test frontal lobe and often used in vascular dementa affected by ACA.
Beck anxiety inventory is a patient self-reported questionnaire designed to assess anxiety in children and adults.
A 45-year-old male states that he has impulses to expose himself that he cannot control. He was brought to the emergency room after being arrested for exposing his genitals to women in public. Which of the following medications would be the most appropriate treatment?
A. Duloxetine
B. Lorazepam
C. Chlorpromazine
D. Ziprasidone
E. Medroxyprogesterone acetate
Answer E
The case describes exhibitionist disorder which is a paraphilia in which patients have the urge to expose their genitals to strangers. Sexual arousal is brought about by the event. Medroxyprogesterone acetate may be helpful in these cases. Antipsychotics and Antidepressants have not been shown to be particularly useful. Some patients may improve with sexual side effects of SSRI’s.
An operant conditioning reinforcement schedule that is used in casino slot machines and may play a role in the development of pathological gambling:
a. fixed-ratio
b. variable – ratio
c. constant interval
d. variable interval
e. fixed interval
Variable ratio: Reinforcement is delivered after an unpredictable number of responses (e.g., after 1, 4, 5, and 9 responses). It has a high and steady response rate. Ex: Gambling
Fixed interval: Reinforcement is delivered at predictable time intervals (e.g., after 5, 10, 15, and 20 minutes). It has a moderate response rate with significant pauses after reinforcement. An example would be a hospital patient uses patient-controlled, doctor-timed pain relief.
Variable interval: Reinforcement is delivered at unpredictable time intervals (e.g., after 5, 7, 10, and 20 minutes). It has a moderate yet steady response rate.
Fixed ratio: Reinforcement is delivered after a predictable number of responses (e.g., after 2, 4, 6, and 8 responses).It has high response rate with pauses after reinforcement. An example would be a factory worker getting paid for every x number of items manufactured.
Deep brain stimulation (deep TMS) targeting which area of the brain is most studied for the treatment of depression?
A. Dorsolateral Prefrontal cortex
B. thalamus
C. Subcallosal cingulate cortex
D. Subthalamic nucleus
c. Subcallosal cingulate cortex
Thalamus: Essential tremor
Subthalamic nucleus: Parkinson's disease
Dorsolateral prefrontal cortex: Area targeted by TMS
Disrupting focal pathological activity in limbic-cortical circuits using electrical stimulation of the subcallosal cingulate cortex can effectively reverse symptoms in otherwise treatment-resistant depression
Other areas targeted in DBS: ventral prefrontal cortex and its connections to the nucleus accumbens and ventral striatum
The Halstead Reitan battery test
A. Measures the executive functioning and reasoning
B. Determines neuropsychological impairment
C. Assesses expressive language
D. Is performed at birth
B
Halstead Reitan battery consists of 10 tests designed to measure elements of memory, abstract thought, language, sensorimotor integration, imperceptions.
It is a comprehensive suite of neuropsychological tests used to assess the condition and functioning of the brain, including etiology, type (diffuse vs. specific), localization and lateralization of brain injury.
Which of the following is not a CYP 3A4 inducer?
A. Rifampin
B. Carbamazepine
C. Phenytoin
D. Fluoxetine
E. Oxcarbazepine
Answer D
All of the listed medications are CYP 3A4 inducers except for fluoxetine which is an inhibitor. Other inhibitors include grapefruit juice, calcium channel blocker’s, Cimetidine, and antifungal’s.
A child is shown a rat and does not produce a fearful response. Then the child is shown the rat with a loud noise (loud noise alone produces a fearful resonse). After several pairing of rat and noise, the child then becomes fearful when just the rat presented alone. In Pavlovian conditioning, what is the conditioned stimulus in this case?
a. the child
b. The loud noise
c. The rat
d. Pavlov
e. B and C
c. The rat. Prior to conditioning (Child shown Rat + Noise at SEVERAL pairings), that loud noise is the the unconditioned stimulus and the rat is the neutral stimulus. After Conditioning, the rat becomes the conditioned stimulus as it produced a fearful response after repeated exposure.
The most common side effect of TMS is
A. headache and dizziness
B. seizure
C. Tinnitus
D. Confusion
e. Amnesia
a. Headache and dizziness
IQs are considered to be stable beginning at age
A. 5 years
B. 8 years
C. 7 years
D. 9 years
7 years
A 64-year-old male with an established history of Huntington’s disease presents to the clinic complaining of abnormal involuntary movements. Which of the following would be the most appropriate therapy:
A. Stereotactic thalamotomy
B. Pramipexole
C. Haloperidol
D. Benztropine
E. Lioresal
Answer C
The chorea in Huntington’s disease usually causes a lurching or stumbling and stuttering gait. The random movements of chorea are accentuated and often most notable during walking. Walking is notably slow with a wide-based stance. Haloperidol reduces chorea but does not improve gait in Huntington’s disease. Stereotactic thalamotomy is a neurosurgical technique designed to alleviate symptoms of Parkinson’s disease. Pramipexole and benztropine are antiparkinsonian medications. Lioresal (baclofen) Is a potent muscle relaxant used in the treatment of muscle spasticity.
Which autoimmune condition is worsened by Lithium use?
a. Rheumatoid Arthritis
b. Systemic Lupus Erythematous
c. Psoriasis
d. Vasculitides
c. psoriasis
The MOA by which lithium exacerbates Psoriasis is not exactly known, but its role in modulating second messenger systems such as adenyl cyclase and inositol monophosphatase–mediated pathways has been implicated. The decrease in cAMP and inositol from lithium causes low intracellular levels of calcium, leading to lack of differentiation and increased proliferation of keratinocytes. Inositol supplementation in psoriatic patients on lithium treatment has demonstrated beneficial effects.
Which of the following is a potential side effect of TMS
A. Psychosis
B. Worsening of depression
C. Induction of mania
D. None of the above
c. Induction of Mania.
Common side effects of TMS are headache or local pain at the site of stimulation and are benign in nature. Severe adverse effects, such as seizures, hearing impairment, or mania, are uncommon.
Which of the following is true about the Trail Making Test?
A. It tests the unconscious drive and psychodynamic processes
B. It is composed of a set of true and false questions
C. It tests attention, visual scanning, and cognitive sequences
C
The Trail Making Test is a neuropsychological test of visual attention and task switching.
It consists of two parts in which the subject is instructed to connect a set of 25 dots as quickly as possible while still maintaining accuracy.
The test can provide information about visual search speed, scanning, speed of processing, mental flexibility, as well as executive functioning.
It is sensitive to detecting cognitive impairment associated with dementia, for example, Alzheimer's disease.
A 26-year-old male with a history of ADHD presents to the clinic seeking treatment. He has been having difficulty concentrating on his college coursework and is interested in medication that is a non-stimulant. He mentions a commercial that he saw on television for Strattera and would like more information. Which one of the following statements is false concerning atomoxetine?
A. Atomoxetine works as a norepinephrine reuptake inhibitor
B. Full results are seen within two weeks of initiating treatment with atomoxetine
C. Once daily dosing of atomoxetine works well for most patients
D. Most common side effects include dizziness and reduced appetite
E. Atomoxetine carries a black box warning for suicidality
Answer B
Atomoxetine is a norepinephrine reuptake inhibitor approved for the treatment of ADHD in children and adults. It may take up to 10 weeks after starting treatments for optimal results. Once daily Dosing works well for most patients. Most common side of flat fix include dizziness, reduce appetite, and dyspepsia. Atomoxetine carries a black box warning for suicidality. It is metabolized primarily by the liver.
What herbal (phytomedicinal) supplement is used as a hypnotic?
a. St. John’s Wort
b. Ginko Biloba
c. Valerian Root
d. Lemongrass
e. Kava Kava
c. Valerian root has sedative and anxiolytic effects. Various compounds have been detected in valerian, including alkaloids, flavonoids, and GABA. Its mechanism of action is not known, but there appears to be affinity for the GABA receptor. Consistent with its sedative properties, valerian can cause drowsiness or dizziness.
Which barbiturate is used to induce a light coma in ECT?
A. pentobarbital
B. primidone
C. methohexital
D. butalbital
c. Methohexital
Among the barbiturates, methohexital and thiopental have minimal anticonvulsant properties compared with other barbiturates. However, due to recent shortages, propofol, etomidate, and ketamine have become more widely used. Pentobarbital, primidone and butalbital are not used for ECT purposes.
Which of the following is true about Stroop Color and Word test?
A.) Words of different colors are printed and words are read by the participant
B.) Words of different colors are printed and colors are read by the participant
B
The Stroop Color and Word Test (SCWT) is used to assess the ability to inhibit cognitive interference that occurs when the processing of a specific stimulus feature impedes the simultaneous processing of a second stimulus attribute, well-known as the Stroop Effect.
Participants are asked to read the colors in which the words are printed. This test can determine disorders such as mental retardation, brain injury, dyslexia, color blindness, prefrontal pathology, acute emotional turmoil and measures cognitive flexibility
A 75-year-old female presents to the outpatient clinic complaining of depressive symptoms including sad mood, decreased appetite with weight loss, anhedonia, difficulty with focus and concentration, and early insomnia. You are considering starting the patient on mirtazapine. Mirtazapine works via action on which of the following receptors?
A. Alpha-2
B. Alpha-1
C. GABA
D. Glutamate
E. D2
Answer A
Mirtazapine works via alpha-2 antagonism on the presynaptic neuron. This blocks of feedback loop causing more serotonin and norepinephrine to be released into the synaptic cleft.
ECT can be considered a first-line treatment for all of the following except:
A. MDD with psychotic features
B. melancholic depression
C.Dangerous levels of exhaustion associated w/ manic
D. Catatonia
E. Chronic, treatment - resistant schizophrenia
e. chronic, treatment-resistant schizophrenia
Which of the following tests only nonverbal tasks?
A. Wechsler Adult Intelligence Test
B. Stanford Binet test
C. Kaufman Assessment Battery for children
D. Ravens Progressive Matrices
Raven's Progressive Matrices
Raven's Progressive Matrices is usually a 60-item test used in measuring abstract reasoning and regarded as a non-verbal estimate of fluid intelligence. Raven's Progressive Matrices is based on pattern recognition.
The Wechsler Adult Intelligence Test and Stanford Binet Test are IQ tests composed of verbal and nonverbal portions.
The Kaufman Assessment Battery for Children is a test of both verbal and nonverbal components designed to measure cognitive ability in children.
Which of the following CYP 450 enzymes is responsible for the metabolism of trazodone?
A. CYP 2D6
B. CYP 2C9
C. CYP 3A4
D. CYP 2C19
E. CYP 1A2
Answer C
Trazodone is metabolized by the CYP 3A4 enzyme
Which of the following is absolute contraindication to ECT?
A. Dementia
B. Cardiac arrhythmia
C. COPD
D. Hx of Epilepsy
e. Brain tumor
f. None of the above
F: None of the above
There is no absolute contra-indication to ECT.
This lobe of the brain is being tested when using the Wisconsin Card Sorting Test.
A. Parietal lobe
B. Frontal lobe
C. Temporal lobe
D. Occipital lobe
B.
A 50 year old schizophrenic mail is under your care. The patient is stable on Clozapine. As his clinician you must be aware of which of the following agents is contraindicated in patients taking clozapine?
A. Fluoxetine
B. Clonazepam
C. Carbamazepine
D. Nortriptyline
E. Lithium
Answer C
Clozapine should not be taken with any other drug that is associated with the development of agranulocytosis or bone marrow suppression. Such agents include carbamazepine, phenytoin, propylthiouracil, sulfonamides, and captopril. Lithium combined with clozapine can increase risk of seizures, confusion, and movement disorders, lithium should not be taken with clozapine if patient has a history of NMS. Clomipramine can increase the seizure risk by lowering the seizure threshold and by increasing clozapine plasma concentration. Fluoxetine, paroxetine, risperidone, and fluvoxamine can all increase the serum levels of clozapine. Paroxetine can also trigger clozapine associated neutropenia.
All of the following are benefits of TMS over ECT except:
a. No need for anesthesia
b. Lower risk of a cardiac event
c. lower risk of delirium
d. Lower risk of induction of mania
e. Lower risk of adverse events in patients with implanted neurotransmitters
Implanted neurotransmitters are considered absolute contra-indication of TMS
A 4-year-old child is administered the "false beliefs task" in which the two dolls act out a scene, whereby one doll switches the location of marble from one site to another, while a second doll leaves the scene of the action.
When the second doll returns to look for the marble, the child correctly points out that it will look in the original location.
This response demonstrates the child is showing evidence of:
A. Theory of Mind
B. Abstractions
C. Object Permanence
Theory of mind is generally tested through a classic 'false-belief' task. This test provides unequivocal evidence that children understand that a person can be mistaken about something they themselves understand.
Theory of mind is the ability to attribute mental states — beliefs, intents, desires, emotions, knowledge, etc. — to oneself and to others.
You have started a 22-year-old female on Lamotrigine. You educate the patient on the risks, benefits, and side effects of the medication. You also inform the patient that interactions with which of the following medication will increase the Lamotrigine levels?
A. Valproic acid
B. Carbamazepine
C. Oral contraceptives
D. Phenytoin
E. Phenobarbital
Answer A
Valproic acid will increase Lamotrigine levels. Oral contraceptives will decrease Oral contraceptives will decrease Lamotrigine levels. Phenytoin and phenobarbital will decrease Phenytoin and phenobarbital will decrease Lamotrigine levels
A 58 year old male with MDD is undergoing ECT treatment, and develops dense retrograde amnesia after the third treatment. How can be prevented by all of the following except:
A. increasing the interval between ECT treatments
b. Ultra-brief stimulation
c. unilateral placement of electrodes
d. Adequate hydration
e. Adequate oxygenation
Hydration has no role in improving the outcome to ECT treatment.
All other answer choices decrease the risk of confusion and amnesia
When a patient makes word choices based on the sound of the word rather than the meaning of the word, this thought process is called:
A. Clanging
B. Derailing
C. Blocking
D. Perseverating
A. Clanging
Clanging refers to a mode of speech characterized by the association of words based upon sound rather than concepts. For example, this may include compulsive rhyming or alliteration without apparent logical connection between words.
Derailing is a thought disorder characterized by discourse consisting of a sequence of unrelated or only remotely related ideas. The frame of reference often changes from one sentence to the next.
Blocking is a phenomenon in which a person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer. When the person begins speaking again, after the block, they will often speak about a subject unrelated to what was being discussed when blocking occurred.
Perseverating is the repetition of a particular response (such as a word, phrase, or gesture) regardless of the absence or cessation of a stimulus.
A 63 year old patient with cancer is given a prognosis of less than 3 weeks to live. This causes him significant depression with symptoms including depressed mood, poor appetite, asthenia (weakness, lack of energy or strength), and poor concentration. What should you prescribe?
a. Amphetamine Salts (Adderall)
b. Methylphenidate (Ritalin)
c. Methamphetamine (Desoxyn)
d. Lisdexamfetamine (Vyvanse)
b. Methylphenidate
In patients with cancer, methylphenidate has been used to manage fatigue, but benefit, particularly in those with mild to moderate fatigue, has been difficult to prove. Benefits are best established in the setting of opioid-induced sedation, cognitive dysfunction associated with brain tumors and depression. Its mechanism of action is stimulation of the central nervous system by blockade of presynaptic norepinephrine and dopamine reuptake. Methylphenidate is usually administered twice a day at breakfast and lunch in order to minimize nighttime insomnia. Assessment of benefit can be relatively rapid.
Which psychological assessment instrument is used to evaluate visual-motor functioning and visual perception skills and both children and adults to identify possible organic brain damage and the degree of maturation of the nervous system?
a. Bender Gestalt Test
b. Vineland adaptive behaviors scale
c. Thematic Apperception test
d. Rorschach Inkblot test
a. Bender Gestalt Test
The Bender Visual Motor Gestalt Test is a psychological test used by mental health practitioners that assesses visual-motor functioning, developmental disorders, and neurological impairments in children ages 3 and older and adults. The test consists of nine index cards picturing different geometric designs. The cards are presented individually and test subjects are asked to copy the design before the next card is shown.
The Rorschach test is a psychological test in which subjects' perceptions of inkblots are recorded and then analyzed using psychological interpretation, complex algorithms, or both. It has been employed to detect underlying thought disorder, especially in cases where patients are reluctant to describe their thinking processes openly.
An eight year old child recently has a Weschsler Intelligence Scale for CHildren performed and received a full-scale IQ of 60. Which additional tests would determine if the child meets criteria for intellectual disability?
A. Thematic apperception test
B. Vineland Adaptive Behavioral Scale
C. Boston Naming Test
D. Halstead Reitan Battery test
B. Vineland Adaptive Behavioral Scale
The Vineland Adaptive Behavior Scale (VABS) is a commonly used measure of adaptive behavior skills for children and adolescents up to 18 years of age. In addition to providing an overall composite score, it consists of three subscales: (a) communication (receptive, expressive, written), (b) socialization (interpersonal relationships, play and leisure, coping skills), and (c) daily living (person, domestic, community).
What drug is the drug that’s used to reverse benzodiazepine-induced sedation following general anesthesia or overdose.
a. Flumanezil
b. plozarenil
c. Ketamine
d. oxacinil
Flumazenil is a non-specific competitive antagonist of the BZD receptor. Use with caution in patients who have developed tolerance to BZDs through chronic use or abuse as administration can precipitate withdrawal seizures.